Safety and efficacy of ivabradine in the treatment of patients with acute myocardial infarction: a real-world propensity score matching study
Authors' conclusion
In this large real-world AMI cohort, in-hospital ivabradine use was associated with higher in-hospital and 1-year mortality, without clear evidence of benefit for other secondary outcomes.
Study context
- Population
- Patients with acute myocardial infarction (AMI) admitted to hospitals in Tianjin, Chinapatients with AMI admitted to 82 hospitals
- Participants
- 136,033 patients
- Comparison
- In-hospital ivabradine use vs controls
- Outcome
- In-hospital mortality and 1-year cardiac mortality
Methodological details82 hospitals in Tianjin, China, 2010 and 2024, pre-specified subgroup analyses
- 82 hospitals in Tianjin, China
- 2010 and 2024
- Pre-specified subgroup analyses
Main finding
As reported in the abstract
In-hospital mortality — ivabradine vs controlsAdjusted odds ratio (95% CI)P value
Higher with ivabradine; after PSM, fully adjusted model
1.66(1.19–2.32)
P = 0.003Higher with ivabradine; after PSM, fully adjusted model. 1-year cardiac mortality — ivabradinevs controls: aHR 1.22 (95% CI 1.01-1.47); P = 0.043; higher with ivabradine; after PSM, fully adjusted model
1.66(1.19–2.32)
P = 0.003Secondary outcomes
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| 1-year all-cause mortality (secondary) | 1.19 (1.01–1.40) | P = 0.040 | |
| 0.512Adjusted hazard ratio (log scale) |
Other secondary outcomes
- No significant differences
Subgroup analyses
- Stronger associations among patients aged ≥65 years
- Mortality association most pronounced among patients receiving ivabradine without concomitant beta-blocker
Sensitivity analyses
- Directionally consistent findings
Original publication
Safety and efficacy of ivabradine in the treatment of patients with acute myocardial infarction: a real-world propensity score matching study. Eur Heart J Acute Cardiovasc Care. Published 15 June 2026. doi:10.
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